Health effects of indoor air pollution on women in Mysore, India

Women in India may face adverse health effects from exposures to fine particulates generated by domestic fuel combustion and due to their role as the primary cook. Typically, studies focused only on the air monitoring or health effects. Using an integrated approach that combines air pollution science with social epidemiology an examination was made regarding the role of socioeconomic status, its interaction with air pollution and resulting health outcomes. The hypotheses were made that (1) women using kerosene would have higher exposures to particulate matter less than 2.5 micrometers in aerodynamic diameter (PM2.5) than women using LPG as their main cooking fuel and therefore (2) kerosene users would have poorer respiratory health than LPG users.The questionnaire, lung function, and exposure monitoring took place during May--June, 2002 and then again in December 2002, in Mysore, India. A questionnaire regarding health, housing environment and socioeconomic status was administered to 40 kerosene and 40 LPG users. These 80 women also participated in spirometry and a subset of 30 was selected for 24-hour gravimetric PM 2.5 personal and indoor exposure monitoring.Results revealed that kerosene users had almost twice the personal and indoor exposures to PM2.5 as LPG users. However, no difference was found in the lung function values between kerosene and LPG users, although both group averages fell below values predicted from previous models. The greatest difference between the two groups was the socioeconomic indicators. Women using LPG were older, wealthier, and better educated and had husbands who were better educated and held more professional jobs than kerosene users. However, the income differential did not account for choice of fuel, since monthly fuel costs were similar for the two groups. However, a large initial investment is needed to switch from kerosene to LPG, which may account for the continuation of kerosene use. Thus, PM2.5 does indeed differ between kerosene and LPG users. However, the impact on lung function remains unclear due to limited data from the Indian population. The results suggest that a government subsidy for the initial cost of LPG would greatly reduce Indian women's PM2.5 exposure.